Environmental Outcomes of Reducing Medication Waste by Redispensing Unused Oral Anticancer Drugs.

Importance: Medications are associated with substantial environmental outcomes, yet frequently end up being unused by patients. Waste-minimizing interventions, such as redispensing of quality-approved oral anticancer drugs remaining unused by patients at home, could reduce the environmental footprint of cancer treatment.

Objectives: To assess the environmental outcomes of redispensing quality-assured oral anticancer drugs and to explore how redispensing could be environmentally optimized.

Integrated maternity care: A concept analysis.

Introduction: Integrated maternity care is strongly promoted in the Netherlands. However, the term 'integrated' and its practical meaning is understood differently by professionals and policy makers. This lack of clarity is also visible in other countries and hinders implementation.

Prospective environmental burdens and benefits of fast-swing direct air carbon capture and storage.

Direct air capture (DAC) in combination with storage of CO can lower atmospheric CO concentrations. This study investigates the environmental impact of a new fast-swing solid sorbent DAC system, including CO transport and storage, over its life cycle, using prospective life cycle assessment. This DAC technology is currently on technology readiness level 5 and is expected to operate on an industrial scale by 2030.

Comparing Environmental Impacts of Single-Junction Silicon and Silicon/Perovskite Tandem Photovoltaics-A Prospective Life Cycle Assessment.

Tandem photovoltaics applying perovskite on silicon are considered to be a possible route to sustaining continuous efficiency improvements and price reductions. A meaningful market share for such tandems is, however, at least a decade away. Herein, a comprehensive prospective life cycle assessment was conducted, comparing the full life cycle of monofacial and bifacial silicon/perovskite tandem panels with single-junction silicon panels produced up to 2050.

Evaluating the Environmental Sustainability of Alternative Ways to Produce Benzene, Toluene, and Xylene.

The petrochemical industry can reduce its environmental impacts by moving from fossil resources to alternative carbon feedstocks. Biomass and plastic waste-based production pathways have recently been developed for benzene, toluene, and xylene (BTX). This study evaluates the environmental impacts of these novel BTX pathways at a commercial and future (2050) scale, combining traditional life cycle assessment with absolute environmental sustainability assessment using the planetary boundary concept.

The potential of emerging bio-based products to reduce environmental impacts.

The current debate on the sustainability of bio-based products questions the environmental benefits of replacing fossil- by bio-resources. Here, we analyze the environmental trade-offs of 98 emerging bio-based materials compared to their fossil counterparts, reported in 130 studies. Although greenhouse gas life cycle emissions for emerging bio-based products are on average 45% lower (-52 to -37%; 95% confidence interval), we found a large variation between individual bio-based products with none of them reaching net-zero emissions.

Competencies Emergency and Mental Health Nurses Need in Triage in Acute Mental Health Care: A Narrative Review.

Introduction: Emergency and mental health nurses are, in many countries, the designated professionals to conduct acute mental health triage. This review aimed to identify competencies these nurses need in major acute health care services such as emergency and accident departments and mental health crisis services for triage for psychiatric patients in crisis.

Methods: For familiarization and construction of an initial thematic framework, we have searched the databases MEDLINE, CINAHL, Academic Search Premier, and PsycINFO since 1975.

Predicting and improving the microbial removal of organic micropollutants during wastewater treatment: A review.

Organic micropollutants (OMPs) consist of widely used chemicals such as pharmaceuticals and pesticides that can persist in surface and groundwaters at low concentrations (ng/L to μg/L) for a long time. The presence of OMPs in water can disrupt aquatic ecosystems and threaten the quality of drinking water sources. Wastewater treatment plants (WWTPs) rely on microorganisms to remove major nutrients from water, but their effectiveness at removing OMPs varies.

The many greenhouse gas footprints of green hydrogen.

Green hydrogen could contribute to climate change mitigation, but its greenhouse gas footprint varies with electricity source and allocation choices. Using life-cycle assessment we conclude that if electricity comes from additional renewable capacity, green hydrogen outperforms fossil-based hydrogen. In the short run, alternative uses of renewable electricity likely achieve greater emission reductions.

Overview on the target population and methods used in care pathway projects: A narrative review.

Background: There is evidence that the efficiency and effectiveness of care processes can be improved in all countries. Care pathways (CPs) are proposed as a method to improve the quality of care by reducing variation. During the last decades, CPs have been intensively used in practice.

Ammonia and chromate interaction explains unresolved Hyalella azteca mortality in Flanders' sediment bioassays.

Agricultural, industrial and household chemicals are emitted in large rivers along populated areas, transported by water and deposited in sediments, posing (eco)toxicological risks. Sediments have received less attention than surface waters, likely because of the intrinsic complexity of interactions between sediment constituents complicating correct framing of exposures. Sadly, thorough assessment of the in situ behavior of sediment constituents in bioassays is often not practical.

A mixed methods multiple case study to evaluate the implementation of a care pathway for colorectal cancer surgery using extended normalization process theory.

Background: Specific factors that facilitate or prevent the implementation of enhanced recovery protocols for colorectal cancer surgery have been described in previous qualitative studies. This study aims to perform a concurrent qualitative and quantitative evaluation of factors associated with successful implementation of a care pathway (CP) for patients undergoing surgery for colorectal cancer.

Methods: This comparative mixed methods multiple case study was based on a sample of 10 hospitals in 4 European countries that implemented a specific CP and performed pre- and post-implementation measurements.

Simulating behavior of petroleum compounds during refinery effluent treatment using the SimpleTreat model.

Distribution and elimination of petroleum products can be predicted in aerobic wastewater treatment plants (WWTPs) using models such as multimedia fate model SimpleTreat. An advantage of the SimpleTreat model is that it only requires a few basic properties of a chemical in wastewater to calculate partitioning, biodegradation and ultimately emissions to air, surface water and produced sludge. The SimpleTreat model structure reflects a WWTP scheme.

Qualitative Evaluation of the Implementation of a Care Pathway for Colorectal Cancer Surgery.

Colorectal cancer care can be standardized by using enhanced recovery protocols. However, adherence to these protocols varies. Using Medical Research Council (MRC) guidance on process evaluations, we examined the experience of health care professionals in the implementation of a care pathway for colorectal surgery, by describing the intervention, context, implementation, mechanisms, and outcomes.

Impact of energy flow optimization on the mitigation of environmental consequences and costs in greenhouse cucumber production.

Cucumber, as a major cultivated plant in Iran, takes up more than 80% of greenhouse production. So, improving the production efficiency can save energy, reduce the environmental consequences and production costs, and also create a lot of job opportunities. The present study aimed to investigate the impact of energy flow optimization on the environmental impacts and costs in greenhouse cucumber production by data envelopment analysis (DEA) and life cycle assessment (LCA) methods.

Chemical footprint of pesticides used in citrus orchards based on canopy deposition and off-target losses.

The application of chemical pesticides is one of the main practices in citrus orchards. But during this operation, a considerable amount of sprayed volume is emitted to off-target areas using air-blast sprayers. The present study aimed to investigate pesticides' toxicological impacts in citrus orchards through determining the proportion of pesticides in different areas (air, soil, and canopy), which facilitate toxicity assessment of pesticides in citrus orchards.

Effects of implementing a care pathway for colorectal cancer surgery in ten European hospitals: an international multicenter pre-post-test study.

Adherence to evidence-based recommendations is variable and generally low. This is also followed in colorectal surgery, despite the availability of the ERAS protocol. The aim of the study was to evaluate the effect of implementing a care pathway for perioperative care in colorectal cancer surgery on outcomes and protocol adherence.

Reliable and representative in silico predictions of freshwater ecotoxicological hazardous concentrations.

A reliable quantification of the potential effects of chemicals on freshwater ecosystems requires ecotoxicological response data for a large set of species which is typically not available in practice. In this study, we propose a method to estimate hazardous concentrations (HCs) of chemicals on freshwater ecosystems by combining two in silico approaches: quantitative structure activity relationships (QSARs) and interspecies correlation estimation (ICE) models. We illustrate the principle of our QSAR-ICE method by quantifying the HCs of 51 chemicals at which 50% and 5% of all species are exposed above the concentration causing acute effects.

Global relative species loss due to first-generation biofuel production for the transport sector.

The global demand for biofuels in the transport sector may lead to significant biodiversity impacts via multiple human pressures. Biodiversity assessments of biofuels, however, seldom simultaneously address several impact pathways, which can lead to biased comparisons with fossil fuels. The goal of the present study was to quantify the direct influence of habitat loss, water consumption and greenhouse gas (GHG) emissions on potential global species richness loss due to the current production of first-generation biodiesel from soybean and rapeseed and bioethanol from sugarcane and corn.

Confronting variability with uncertainty in the ecotoxicological impact assessment of down-the-drain products.

The use of down-the-drain products and the resultant release of chemicals may lead to pressures on the freshwater environment. Ecotoxicological impact assessment is a commonly used approach to assess chemical products but is still influenced by several uncertainty and variability sources. As a result, the robustness and reliability of such assessments can be questioned.

Protocol for process evaluation of evidence-based care pathways: the case of colorectal cancer surgery.

Background And Aim: Care pathways are complex interventions, consisting of multiple 'active ingredients', to structure care processes around patient needs. Numerous studies have reported improved outcomes after implementation of care pathways. The structure-process-outcome framework and the context-mechanism-outcome framework both suggest that outcomes can only be achieved through a certain process within a context or structure.

Quantifying variability in removal efficiencies of chemicals in activated sludge wastewater treatment plants - a meta-analytical approach.

Large variations in removal efficiencies (REs) of chemicals have been reported for monitoring studies of activated sludge wastewater treatment plants (WWTPs). In this work, we conducted a meta-analysis on REs (1539 data points) for a set of 209 chemicals consisting of fragrances, surfactants, and pharmaceuticals in order to assess the drivers of the variability relating to inherent properties of the chemicals and operational parameters of activated sludge WWTPs. For a reduced dataset (n = 542), we developed a mixed-effect model (meta-regression) to explore the observed variability in REs for the chemicals using three chemical specific factors and four WWTP-related parameters.